C-reactive protein

C-reactive protein, pentraxin-related
Identifiers
Symbols	CRP ; MGC149895; MGC88244; PTX1
External IDs	Template:OMIM5 Template:MGI HomoloGene: 476
Gene ontology Molecular function Template:GNF GO Template:GNF GO Cellular component Template:GNF GO Biological process Template:GNF GO Template:GNF GO
RNA expression pattern
More reference expression data
Orthologs
Template:GNF Ortholog box
Species	Human	Mouse
Entrez	n/a	n/a
Ensembl	n/a	n/a
UniProt	n/a	n/a
RefSeq (mRNA)	n/a	n/a
RefSeq (protein)	n/a	n/a
Location (UCSC)	n/a	n/a
PubMed search	n/a	n/a

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

Overview

C-reactive protein (CRP) is a plasma protein, an acute phase protein produced by the liver. It is a member of the pentraxin family of proteins. It should not be confused with C-peptide or Protein C.

C-reactive protein (CRP) is an inflammatory marker with a very large body of evidence demonstrating its prognostic utility in apparently healthy patients, as well as patients with acute coronary syndromes. Pre-angioplasty levels of CRP predict outcome, CRP levels rise after angioplasty, and it appears that the rise can be blunted by GP IIb/IIIa inhibitors.

History and nomenclature

C-reactive protein was originally discovered by Tillett and Francis in 1930 as a substance in the serum of patients with acute inflammation that reacted with the C polysaccharide of pneumococcus. Initially it was thought that CRP might be a pathogenic secretion, as it was elevated in people with a variety of illnesses, including carcinomas. Discovery of hepatic synthesis and secretion of CRP closed that debate

Genetics and biochemistry

The CRP gene is located on the first chromosome (1q21-q23). CRP is a 224 residue protein with a monomer molar mass of 25106 Da. The protein is an annular pentameric disc in shape. Proteins with this type of configuration are known as pentraxins. Native CRP is a bit different as it has 10-subunits making two pentameric discs, with an overall molecular mass of 251060 Da.

Pathophysiology

In the field of atherosclerosis, it is unclear if CRP plays a putative role in disease or is a marker of ongoing disease.

• C-reactive protein (CRP) is an acute phase protein formed in the liver. The stimulus for CRP production is IL-6.
• CRP rises more than 6 hours after triggering stimulus
• Upon resolution of condition, CRP rapidly declines
• CRP is considered to be a better indicator for an inflammatory response because of its shorter half-life and rapid increase

Function

CRP is a member of the class of acute phase reactants as its levels rise dramatically during inflammatory processes occurring in the body. This increment is due to a rise in the plasma concentration of IL-6, which is produced by macrophages, endothelial cells and T-cells as well as adipocytes. CRP binds to phosphorylcholine on microbes. It is thought to assist in complement binding to foreign and damaged cells and enhances phagocytosis by macrophages, which express a receptor for CRP. It is also believed to play an important role in innate immunity, as an early defense system against infections.

Diagnostic use

CRP is used mainly as a marker of inflammation. Measuring and charting C-reactive protein values can prove useful in determining disease progress or the effectiveness of treatments. Blood, usually collected in a serum-separating tube, is analysed in a medical laboratory or at the point of testing.

Various analytical methods are available for CRP determination, such as ELISA, immunoturbidimetry, rapid immunodiffusion and visual agglutination.

Viral infections tend to give a lower CRP level than bacterial infection.

Cardiology diagnostic test

Arterial damage is thought to result from inflammation due to chemical insults. CRP is a general marker for inflammation and infection, so it can be used as a very rough proxy for heart disease risk. Since many things can cause elevated CRP, this is not a very specific prognostic indicator. Also, these values refer only to prolonged elevation, so a single measurement would be meaningless.

C-reactive protein blood test

Low risk: <1mg/L

High risk: >3mg/L

Differential Diagnosis

Most common

• Acute pancreatitis
• Bacteria
• Bechterew's Disease
• Degenerative joint diseases
• Dermatomyositis
• Fungi
• Inflammatory Bowel Disease
• Juvenile Arthritis
• Leukemia
• Malignant tumors
• Myocardial Infarction
• Parasites
• Polymyalgia Rheumatica
• Polymyositis
• Postoperatively
• Post Percutaneous Coronary Intervention (PCI)
• Pseudogout
• Psoriasis arthropathy
• Reiter's Syndrome
• Rheumatoid Arthritis
• Sjogren's Syndrome
• Systemic Lupus Erythematosus
• Vasculitis
• Viruses
• Wegener's Granulomatosis

Complete Differential Diagnosis

(By organ system)

Cardiovascular	Amyloidosis,Catecholaminergic polymorphic ventricular tachycardia,Myocarditis,Ventricular Tachycardia Including Torsades De Pointes and Polymorphic Ventricular Tachycardia,Abdominal Aortic Aneurysm,Acute Coronary Syndromes,Arrhythmogenic right ventricular dysplasia,Atherosclerosis,Brugada syndrome,Cardiomyopathy,Congestive Heart Failure,Hypertrophic Cardiomyopathy,Myocardial infarction,Peripheral Arterial Disease,Romano-Ward syndrome,Shock (medical),Stress cardiomyopathy,Subclavian Artery Disease,Down syndrome,Noonan syndrome,Andersen-Tawil syndrome,Pseudoxanthoma elasticum,Rheumatic fever,Homocystinuria,Ehlers-Danlos syndrome,Friedreich's ataxia,Williams syndrome
Chemical / poisoning	No underlying causes
Dermatologic	Acrodermatitis enteropathica,Porphyria cutanea tarda,Squamous cell carcinoma,Acne vulgaris,Contact dermatitis,Eczema,Pachyonychia congenita,Pemphigus,Scleroderma,Neurofibromatosis
Drug Side Effect	Abciximab,Adalimumab,Anakinra,Aspirin,Boldenone,Clarithromycin,Clindamycin,Corticosteroid,Demeclocycline,Dexamethasone,Doxycycline,Drospirenone,Erythromycin,Estrogen,Flunisolide Oral Inhalation,Fluoxetine,Fluticasone and Salmeterol Oral Inhalation,Fluvoxamine,Hydrocortisone Oral,Ibuprofen,Imatinib,Ketamine,Ketorolac,Tacrolimus,Triamcinolone Oral Inhalation,Heparin Induced Thrombocytopenia
Ear Nose Throat	Collagenopathy, types II and XI,Wolfram syndrome,Ear infections,Down syndrome
Endocrine	Diabetes mellitus,Diabetic ketoacidosis,Diabetic nephropathy,Glucagonoma,Graves' Disease,Growth hormone deficiency,Hypothyroidism,Lipoid congenital adrenal hyperplasia,McCune-Albright syndrome,Catecholaminergic polymorphic ventricular tachycardia,Wolfram syndrome,Werner syndrome,X-linked adrenal hypoplasia congenita,Peroxisomal disorder,Neuroendocrine tumors,Thyroid Carcinoma,Pendred syndrome,Down syndrome
Environmental	Andrographis paniculata,Nylon worker's lung,Toxic and Nutritional Optic Neuropathy
Gastroenterologic	Ascites,Autoimmune Hepatitis,Budd-Chiari syndrome,Celiac disease,Cholecystitis,Chronic pancreatitis,Cirrhosis,Colitis,Crohn's disease,Diarrhea,Eosinophilic gastroenteritis,Peutz-Jeghers syndrome,Shwachman-Diamond syndrome,Spontaneous bacterial peritonitis,Typhoid fever,Wilson's disease,Amyloidosis,Acrodermatitis enteropathica,Wilson's disease,Cystic Fibrosis,Dubin-Johnson syndrome,Primary biliary cirrhosis,Hemochromatosis,Zellweger syndrome,Gaucher's disease,Protein-Losing Enteropathy,Gastrointestinal stromal tumor,Hepatocellular carcinoma,Ulcerative colitis,Hepatitis B,Hepatitis C/co-infection with HIV,Hepatitis G,Hepatitis,Sarcoidosis,Rett syndrome,Sandhoff disease,Polycystic kidney disease,Salla disease,Down syndrome
Genetic	Allan-Herndon-Dudley syndrome,Alport syndrome,Andersen-Tawil syndrome,ASPM (Genetics),Ataxia Telangiectasia,Atransferrinemia,Bloom syndrome,Cardiofaciocutaneous syndrome,Chronic granulomatous disease,Congenital Adrenal Hyperplasia,Congenital muscular dystrophy,Cystic Fibrosis,Down syndrome,Dubin-Johnson syndrome,Familial Mediterranean fever,Friedreich's ataxia,Myotonia congenita,Myotonic dystrophy,Neurofibromatosis,Niemann-Pick disease,Noonan syndrome,Osteogenesis imperfecta,Otospondylomegaepiphyseal dysplasia,Pachyonychia congenita,Pendred syndrome,Polycystic kidney disease,Primary biliary cirrhosis,Primary ciliary dyskinesia,Pseudoxanthoma elasticum,Rett syndrome,Rubinstein-Taybi syndrome,Salla disease,Sickle-cell disease,Stargardt's disease,Tay-Sachs Disease,Treacher Collins syndrome,Usher syndrome,Vitelliform macular dystrophy,Von Hippel-Lindau disease,,Von Willebrand disease,Waldenstrom macroglobulinemia,Walker-Warburg syndrome,Werner syndrome,Williams syndrome,Wiskott-Aldrich syndrome,Wolfram syndrome,X-linked adrenal hypoplasia congenita,X-linked alpha thalassemia mental retardation syndrome,X-linked congenital stationary night blindness,ZAP70 deficiency,Norrie disease,Shwachman-Diamond syndrome,SADDAN,Cystinuria,Sandhoff disease
Hematologic	Abetalipoproteinemia,Activated protein C resistance,Acute myeloid leukemia,Anemia,Angiogenesis,Angiopathy,Antiphospholipid syndrome,Arteriogenesis,Blood transfusion,Cryoglobulinemia,Disseminated Intravascular Coagulation,Fanconi anemia,Fat Embolism Syndrome,Hemochromatosis,Hemoglobinuria,Heparin Induced Thrombocytopenia,Multiple myeloma,Protein S deficiency,Thrombocytopenia,Thrombocytosis,Thrombotic thrombocytopenic purpura,Porphyria cutanea tarda,Wiskott-Aldrich syndrome,Atransferrinemia,Sickle-cell disease,Von Hippel-Lindau disease,Von Willebrand disease,Waldenstrom macroglobulinemia,X-linked alpha thalassemia mental retardation syndrome,Cavernous Sinus Thrombosis,Gaucher's disease
Iatrogenic	Antithrombin Therapy During Percutaneous Coronary Intervention (PCI) (patient information),Heparin Induced Thrombocytopenia
Infectious Disease	Bacterial: Leptospira,Pseudomonas aeruginosa,Relapsing fever,Rheumatic fever,Sepsis,Streptococcus pneumoniae,Syphillis,Tetanus,Tick-borne meningoencephalitis,Tuberculosis,Chlamydia,Cholera,Group A streptococcal infection,Tuberculosis,Lung abscess,Meningitis,Brain Abscess,Saccharopolyspora rectivirgula,Bacteremia Fungal: Aspergillus clavatus,Thermoactinomyces sacchari,Thermoactinomyces vulgaris,Coccidioidal Meningitis Helminthic: Hookworm infection,Schistosomiasis Protozoal: Cladosporium,Malaria Viral: Lentivirus,Non-Polio enterovirus infections,Poliomyelitis,Rabies,Yellow fever,Anthrax,Foot-and-mouth disease,Hantavirus pulmonary syndrome,Hepatitis B,Hepatitis C/co-infection with HIV,Hepatitis G,,Herpes simplex,HIV,Influenza,Lassa Fever,Severe acute respiratory syndrome,Smallpox,Vaccinia,Encephalitis,Myocarditis
Musculoskeletal / Ortho	Achondrogenesis,Collagenopathy, types II and XI,Duchenne's Muscular Dystrophy,Dysarthria,Ehlers-Danlos syndrome,Emery-Dreifuss Muscular Dystrophy,Fibrodysplasia ossificans progressiva,Osteoarthritis,Osteomalacia,Osteoporosis,SADDAN,Still's disease,McCune-Albright syndrome,Rubinstein-Taybi syndrome,Allan-Herndon-Dudley syndrome,Congenital muscular dystrophy,Myotonia congenita,Myotonic dystrophy,Osteogenesis imperfecta,Otospondylomegaepiphyseal dysplasia,Treacher Collins syndrome,Gout,Rheumatoid arthritis,Polymyositis,Noonan syndrome,Rheumatic fever,Poliomyelitis,Salla disease,Vitelliform macular dystrophy,Walker-Warburg syndrome
Neurologic	Acute Disseminated Encephalomyelitis,Adrenoleukodystrophy,Amyotrophic Lateral Sclerosis,Asceptic Meningitis,Astrocytoma,Benign familial neonatal convulsions,Bovine spongiform encephalopathy,Brain Abscess,Cavernous angioma,Cavernous Sinus Thrombosis,Cerebral edema,Cerebral hemorrhage,Coccidioidal Meningitis,Creutzfeldt-Jakob Disease,Ddx:Meningitis,Devic's disease,Encephalitis,Encephalopathy,Epilepsy,Experimental autoimmune encephalomyelitis,Glioblastoma multiforme,Juvenile myoclonic epilepsy,Meningioma,Multiple sclerosis,Zellweger syndrome,Walker-Warburg syndrome,Friedreich's ataxia,Williams syndrome,Neurofibromatosis,Pendred syndrome,Rett syndrome,Ataxia Telangiectasia,Poliomyelitis,Rabies,Tick-borne meningoencephalitis,Sandhoff disease,Down syndrome,Wilson's disease,Rubinstein-Taybi syndrome,Niemann-Pick disease,Polycystic kidney disease (Berry anuerysms),Gaucher's disease,Amyloidosis,Ehlers-Danlos syndrome
Nutritional / Metabolic	Biotinidase deficiency,Carbamoyl phosphate synthetase I deficiency,Carnitine palmitoyltransferase II deficiency,Citrullinemia,Cystinuria,Gaucher's disease,Glutaric acidemia type 2,Glutaric aciduria type 1,Glycogen storage disease type I,GM2-gangliosidosis, AB variant,Gout,High protein diet,Homocystinuria,Hurler's Syndrome,Hyperlipidemia,Hypermethioninemia,Hyperprolinemia,Isovaleric acidemia,Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes,Paraproteinemia,Pellagra,Peroxisomal disorder,Phenylketonuria,Propionic acidemia,Protein-energy malnutrition,Protein-Losing Enteropathy,Sandhoff disease,Tyrosinemia,Urea cycle disorder,Uremia,Toxic and Nutritional Optic Neuropathy,Salla disease,Niemann-Pick disease,Tay-Sachs Disease,Osteomalacia,Nephrotic syndrome,Soy allergy,Acrodermatitis enteropathica,Porphyria cutanea tarda
Obstetric/Gynecologic	Endometriosis,Hydatidiform mole
Oncologic	Adenoid cystic carcinoma,Breast cancer,Cervical cancer,Gastrointestinal stromal tumor,Hepatocellular carcinoma,Melanoma,Mesothelioma,Neuroendocrine tumors,Paraneoplastic syndrome,Thyroid Carcinoma,Squamous cell carcinoma,Glucagonoma,Peutz-Jeghers syndrome,Astrocytoma,Cavernous angioma,Glioblastoma multiforme,Meningioma,Bladder cancer,Prostate cancer
Opthalmologic	Arteritic anterior ischemic optic neuropathy,Corneal ulcer,Drusen,Keratoconjunctivitis sicca,Vitelliform macular dystrophy,Stargardt's disease,X-linked congenital stationary night blindness,Norrie disease,Collagenopathy, types II and XI,Wolfram syndrome,Walker-Warburg syndrome,Toxic and Nutritional Optic Neuropathy,Wilson's disease,Ehlers-Danlos syndrome,Down syndrome
Overdose / Toxicity	No underlying causes
Psychiatric	Bipolar disorder
Pulmonary	Lung abscess,Hypersensitivity Pneumonitis,Atypical pneumonia,Bird breeder's lung,Bronchitis,Byssinosis,Cheese worker's lung,Chemical worker's lung,Emphysema,Grain handler's lung,Hot tub lung,Humidifier lung,Infant respiratory distress syndrome,Loeffler's syndrome,Malt worker's lung,Nylon worker's lung,Primary ciliary dyskinesia,Pleural Effusion,Pneumonia,Pseudomonas aeruginosa,Tuberculosis,Severe acute respiratory syndrome,Saccharopolyspora rectivirgula,Amyloidosis,Cystic Fibrosis,Sarcoidosis
Renal / Electrolyte	Nephrotic syndrome,Acidosis,Androgen insensitivity syndrome,Chronic Renal Failure,Hypercalcemia,Focal segmental glomerulosclerosis,Gitelman syndrome,Glomerulonephritis,Hyperammonemia,Hyperkalemic periodic paralysis,Hypernatremia,Nephronophthisis,Diabetic nephropathy,Polycystic kidney disease,Alport syndrome,Congenital Adrenal Hyperplasia,Adrenoleukodystrophy,ZAP70 deficiency,Thrombotic thrombocytopenic purpura,Zellweger syndrome,Cystinuria
Rheum / Immune / Allergy	Rheumatology: Ulcerative colitis,Rheumatoid arthritis,Scleroderma,Sarcoidosis,Polymyositis,Ankylosing Spondylitis,Reactive Polyarticular Arthritis Immunology: Soy allergy,Pemphigus,Hepatitis,Angioedema,Autoimmune polyendocrine syndrome,Food allergy,Graft-versus-host disease,Hyperimmunoglobulinemia D with recurrent fever,Mollusk shell hypersensitivity,Systemic lupus erythematosus,Vitiligo,Chronic granulomatous disease,Hypersensitivity Pneumonitis
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	Bladder cancer,Prostate cancer
Dental	Amelogenesis Imperfecta,Ehlers-Danlos syndrome
Miscellaneous	Atrophy,Bone healing,Botulinum toxin,Brachioradial pruritis,Erythropoietin,Excitotoxicity,Snakebites,Total Parenteral Nutrition

Complete Differential Diagnosis

(In alphabetical order)

1. Abciximab (patient information)
2. Abdominal Aortic Aneurysm
3. Abetalipoproteinemia
4. Achondrogenesis
5. Acidosis
6. Acne vulgaris
7. Acrodermatitis enteropathica
8. Activated protein C resistance
9. Acute Coronary Syndromes
10. Acute Disseminated Encephalomyelitis
11. Acute myeloid leukemia
12. Adalimumab
13. Adenoid cystic carcinoma
14. Adrenoleukodystrophy
15. Allan-Herndon-Dudley syndrome
16. Alport syndrome
17. Amelogenesis Imperfecta
18. Amyloidosis
19. Amyotrophic Lateral Sclerosis
20. Anakinra (patient information)
21. Andersen-Tawil syndrome
22. Androgen insensitivity syndrome
23. Andrographis paniculata
24. Anemia
25. Angioedema
26. Angiogenesis
27. Angiopathy
28. Ankylosing Spondylitis
29. Anthrax
30. Antiphospholipid syndrome
31. Antithrombin Therapy During Percutaneous Coronary Intervention (PCI) (patient information)
32. Aortic aneurysm
33. Arrhythmogenic right ventricular dysplasia
34. Arteriogenesis
35. Arteritic anterior ischemic optic neuropathy
36. Asceptic Meningitis
37. Ascites
38. Aspergillus clavatus
39. Aspirin
40. ASPM (Genetics)
41. Astrocytoma
42. Ataxia Telangiectasia
43. Atherosclerosis
44. Atransferrinemia
45. Atrophy
46. Atypical pneumonia
47. Autoimmune Hepatitis
48. Autoimmune polyendocrine syndrome
49. Benign familial neonatal convulsions
50. Biotinidase deficiency
51. Bipolar disorder
52. Bird breeder's lung
53. Bladder cancer
54. Blood transfusion
55. Bloom syndrome
56. Boldenone
57. Bone healing
58. Botulinum toxin
59. Bovine spongiform encephalopathy
60. Brachioradial pruritis
61. Brain Abscess
62. Breast cancer
63. Bronchitis
64. Brugada syndrome
65. Budd-Chiari syndrome
66. Byssinosis
67. Carbamoyl phosphate synthetase I deficiency
68. Cardiofaciocutaneous syndrome
69. Cardiomyopathy
70. Cardiovascular Effects of Cocaine
71. Carnitine palmitoyltransferase II deficiency
72. Catecholaminergic polymorphic ventricular tachycardia
73. Cavernous angioma
74. Cavernous Sinus Thrombosis
75. Celiac disease
76. Cerebral edema
77. Cerebral hemorrhage
78. Cervical cancer
79. Cheese worker's lung
80. Chemical worker's lung
81. Cholecystitis
82. Cholera
83. Chronic granulomatous disease
84. Chronic pancreatitis
85. Chronic Renal Failure
86. Cirrhosis
87. Citrullinemia
88. Cladosporium
89. Clarithromycin
90. Clindamycin
91. Coccidioidal Meningitis
92. Colitis
93. Collagenopathy, types II and XI
94. Congenital Adrenal Hyperplasia
95. Congenital muscular dystrophy
96. Congestive Heart Failure
97. Contact dermatitis
98. Corneal ulcer
99. Corticosteroid
100. Creutzfeldt-Jakob Disease
101. Crohn's disease
102. Cryoglobulinemia
103. Cystic Fibrosis
104. Cystinuria
105. Ddx:Hypercalcemia
106. Ddx:Meningitis
107. Demeclocycline
108. Devic's disease
109. Dexamethasone
110. Diabetes mellitus
111. Diabetic ketoacidosis
112. Diabetic nephropathy
113. Diarrhea
114. Disseminated Intravascular Coagulation
115. Down syndrome
116. Doxycycline
117. Drospirenone
118. Drusen
119. Dubin-Johnson syndrome
120. Duchenne's Muscular Dystrophy
121. Dysarthria
122. Eczema
123. Ehlers-Danlos syndrome
124. Emery-Dreifuss Muscular Dystrophy
125. Emphysema
126. Encephalitis
127. Encephalopathy
128. Endometriosis
129. Eosinophilic gastroenteritis
130. Epilepsy
131. Erythromycin
132. Erythropoietin
133. Estrogen
134. Excitotoxicity
135. Experimental autoimmune encephalomyelitis
136. Familial Mediterranean fever
137. Fanconi anemia
138. Fat Embolism Syndrome
139. Fibrodysplasia ossificans progressiva
140. Flunisolide Oral Inhalation (patient information)
141. Fluoxetine
142. Fluticasone and Salmeterol Oral Inhalation (patient information)
143. Fluvoxamine
144. Focal segmental glomerulosclerosis
145. Food allergy
146. Foot-and-mouth disease
147. Friedreich's ataxia
148. Gastrointestinal stromal tumor
149. Gaucher's disease
150. Gitelman syndrome
151. Glioblastoma multiforme
152. Glomerulonephritis
153. Glucagonoma
154. Glutaric acidemia type 2
155. Glutaric aciduria type 1
156. Glycogen storage disease type I
157. GM2-gangliosidosis, AB variant
158. Gout
159. Graft-versus-host disease
160. Grain handler's lung
161. Graves' Disease
162. Group A streptococcal infection
163. Growth hormone deficiency
164. Hantavirus pulmonary syndrome
165. Hemochromatosis
166. Hemoglobinuria
167. Heparin Induced Thrombocytopenia
168. Hepatitis
169. Hepatitis B
170. Hepatitis C/co-infection with HIV
171. Hepatitis G
172. Hepatocellular carcinoma
173. Herpes simplex
174. High protein diet
175. HIV
176. Homocystinuria
177. Hookworm infection
178. Hot tub lung
179. Humidifier lung
180. Hurler's Syndrome
181. Hydatidiform mole
182. Hydrocortisone Oral (patient information)
183. Hyperammonemia
184. Hypercalcemia
185. Hyperimmunoglobulinemia D with recurrent fever
186. Hyperkalemic periodic paralysis
187. Hyperlipidemia
188. Hypermethioninemia
189. Hypernatremia
190. Hyperprolinemia
191. Hypersensitivity Pneumonitis
192. Hypertrophic Cardiomyopathy
193. Hypothyroidism
194. Ibuprofen
195. Imatinib (patient information)
196. Infant respiratory distress syndrome
197. Influenza
198. Isovaleric acidemia
199. Juvenile myoclonic epilepsy
200. Keratoconjunctivitis sicca
201. Ketamine
202. Ketorolac
203. Lactobacillus
204. Lactobacillus reuteri
205. LÃffler's syndrome
206. Lassa Fever
207. Latent tuberculosis
208. Lentivirus
209. Leptospira
210. Lipoid congenital adrenal hyperplasia
211. Lung abscess
212. Malaria
213. Malt worker's lung
214. McCune-Albright syndrome
215. Melanoma
216. Meningioma
217. Mesothelioma
218. Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes
219. Mollusk shell hypersensitivity
220. Multiple myeloma
221. Multiple sclerosis
222. Myocardial infarction
223. Myocarditis
224. Myotonia congenita
225. Myotonic dystrophy
226. Nephronophthisis
227. Nephrotic syndrome
228. Neuroendocrine tumors
229. Neurofibromatosis
230. Niemann-Pick disease
231. Non-Polio enterovirus infections
232. Noonan syndrome
233. Norrie disease
234. Nylon worker's lung
235. Osteoarthritis
236. Osteogenesis imperfecta
237. Osteomalacia
238. Osteoporosis
239. Otospondylomegaepiphyseal dysplasia
240. Pachyonychia congenita
241. Paraneoplastic syndrome
242. Paraproteinemia
243. Pellagra
244. Pemphigus
245. Pendred syndrome
246. Peripheral Arterial Disease
247. Peroxisomal disorder
248. Peutz-Jeghers syndrome
249. Phenylketonuria
250. Pleural Effusion
251. Pneumonia
252. Poliomyelitis
253. Polycystic kidney disease
254. Polymyositis
255. Porphyria cutanea tarda
256. Primary biliary cirrhosis
257. Primary ciliary dyskinesia
258. Propionic acidemia
259. Prostate cancer
260. Protein S deficiency
261. Protein-energy malnutrition
262. Protein-Losing Enteropathy
263. Pseudomonas aeruginosa
264. Pseudoxanthoma elasticum
265. Rabies
266. Reactive Polyarticular Arthritis
267. Relapsing fever
268. Rett syndrome
269. Rheumatic fever
270. Rheumatoid arthritis
271. Romano-Ward syndrome
272. Rubinstein-Taybi syndrome
273. Saccharopolyspora rectivirgula
274. SADDAN
275. Salla disease
276. Sandhoff disease
277. Sarcoidosis
278. Schistosomiasis
279. Scleroderma
280. Sepsis
281. Severe acute respiratory syndrome
282. Shock (medical)
283. Shwachman-Diamond syndrome
284. Sickle-cell disease
285. Sitophilus granarius
286. Smallpox
287. Snakebites
288. Soy allergy
289. Spontaneous bacterial peritonitis
290. Squamous cell carcinoma
291. Stargardt's disease
292. Still's disease
293. Streptococcus pneumoniae
294. Stress cardiomyopathy
295. Subclavian Artery Disease
296. Syphillis
297. Systemic lupus erythematosus
298. Tacrolimus
299. Tay-Sachs Disease
300. Tetanus
301. Thermoactinomyces sacchari
302. Thermoactinomyces vulgaris
303. Thrombocytopenia
304. Thrombocytosis
305. Thrombotic thrombocytopenic purpura
306. Thyroid Carcinoma
307. Tick paralysis
308. Tick-borne meningoencephalitis
309. Total Parenteral Nutrition (patient information)
310. Toxic and Nutritional Optic Neuropathy
311. Treacher Collins syndrome
312. Triamcinolone Oral Inhalation (patient information)
313. Tuberculosis
314. Typhoid fever
315. Tyrosinemia
316. Ulcerative colitis
317. Urea cycle disorder
318. Uremia
319. Usher syndrome
320. Vaccinia
321. Ventricular Tachycardia Including Torsades De Pointes and Polymorphic Ventricular Tachycardia
322. Vitelliform macular dystrophy
323. Vitiligo
324. Von Hippel-Lindau disease
325. Von Willebrand disease
326. Waldenström macroglobulinemia
327. Walker-Warburg syndrome
328. Werner syndrome
329. Williams syndrome
330. Wilson's disease
331. Wiskott-Aldrich syndrome
332. Wolfram syndrome
333. X-linked adrenal hypoplasia congenita
334. X-linked alpha thalassemia mental retardation syndrome
335. X-linked congenital stationary night blindness
336. Yellow fever
337. ZAP70 deficiency
338. Zellweger syndrome

Role in cardiovascular disease

Recent research suggests that patients with elevated basal levels of CRP are at an increased risk for diabetes, hypertension and cardiovascular disease. A study of over 700 nurses showed that those in the highest quartile of trans fat consumption had blood levels of C-reactive protein (CRP, a pro-inflammatory cytokine which is a cardiovascular disease risk factor) that were 73% higher than those in the lowest quartile. Although one group of researchers indicated that CRP may only be a moderate risk factor for cardiovascular disease, this study (known as the Reykjavik Study) was found to have some problems for this type of analysis related to the characteristics of the population studied, and there was an extremely long follow-up time which may have attenuated the association between CRP and future outcomes. Others have shown that CRP can exacerbate ischemic necrosis in a complement-dependent fashion and that CRP inhibition can be a safe and effective therapy for myocardial and cerebral infarcts.

To measure the CRP level, a "high-sensitivity" CRP or hs-CRP test needs to be performed and analyzed by a laboratory. This is an automated blood test designed for greater accuracy in measuring low levels of CRP, which allows the physician to assess cardiovascular risk. If a result in the low-risk range is found ( < 1 mg/L), it does not need repeating. Higher levels need repeating, and clinical evaluation as necessary.

Role in colon cancer

The role of inflammation in cancer is not well known. Some organs of the body show greater risk of cancer when they are chronically inflamed.

Blood samples of persons with colon cancer have an average CRP concentration of 2.69 milligrams per liter. Persons without colon cancer average 1.97 milligrams per liter. The difference was statistically significant. These findings concur with previous studies that indicate that anti-inflammatory drugs could lower colon cancer risk.

Related chapters

• acute phase
• erythrocyte sedimentation rate
• immunology
• Cardiology diagnostic tests and procedures

Additional images

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  C-reactive protein

Resources

• MedlinePlus Encyclopedia 003356
• Inflammation, Heart Disease and Stroke: The Role of C-Reactive Protein (American Heart Association)
• C-Reactive+Protein at the US National Library of Medicine Medical Subject Headings (MeSH)